Abstract
BackgroundArtificially sweetened beverage consumption has steadily increased in the last 40 years. Several reviews examining the effects of artificially sweetened beverages on weight outcomes have discrepancies in their results and conclusions.ObjectivesTo determine whether risk of bias, results, and conclusions of reviews of effects of artificially sweetened beverage consumption on weight outcomes differ depending on review sponsorship and authors’ financial conflicts of interest.MethodsWe performed a systematic review of reviews of the effects of artificially sweetened beverages on weight. Two assessors independently screened articles for inclusion, extracted data, and assessed risks of bias. We compared risk of bias, results and conclusions of reviews by different industry sponsors, authors’ financial conflict of interest and journal sponsor. We also report the concordance between review results and conclusions.ResultsArtificial sweetener industry sponsored reviews were more likely to have favorable results (3/4) than non-industry sponsored reviews (1/23), RR: 17.25 (95% CI: 2.34 to 127.29), as well as favorable conclusions (4/4 vs. 15/23), RR: 1.52 (95% CI: 1.14 to 2.06). All reviews funded by competitor industries reported unfavorable conclusions (4/4). In 42% of the reviews (13/31), authors’ financial conflicts of interest were not disclosed. Reviews performed by authors that had a financial conflict of interest with the food industry (disclosed in the article or not) were more likely to have favorable conclusions (18/22) than reviews performed by authors without conflicts of interest (4/9), RR: 7.36 (95% CI: 1.15 to 47.22). Risk of bias was similar and high in most of the reviews.ConclusionsReview sponsorship and authors’ financial conflicts of interest introduced bias affecting the outcomes of reviews of artificially sweetened beverage effects on weight that could not be explained by other sources of bias.
Highlights
The global obesity epidemic represents one of the biggest public health challenges of our time: there are currently 600 million adults and 42 million children that are obese [1]
Artificial sweetener industry sponsored reviews were more likely to have favorable results (3/4) than non-industry sponsored reviews (1/23), Risk Ratios (RR): 17.25, as PLOS ONE | DOI:10.1371/journal.pone
All four reviews funded by competitors of the artificial sweetener industry reported unfavorable conclusions (4/4) and all four reviews funded by the artificial sweetener industry had favorable conclusions, RR: 1
Summary
The global obesity epidemic represents one of the biggest public health challenges of our time: there are currently 600 million adults and 42 million children that are obese [1]. Overweight and obesity are associated with increased risk for a variety of chronic and debilitating diseases including cancer, cardiovascular disease and diabetes [2]. While no single factor is responsible for the recent increases in overweight and obesity, excess calories and inadequate physical activity are known determinants [4]. Added sugars are a significant source of excess calories and sugar-sweetened beverages are one of the main sources of added sugars, with an estimated 184 000 annual deaths attributable to their consumption worldwide [5, 6]. Sweetened beverage consumption has steadily increased in the last 40 years. Several reviews examining the effects of artificially sweetened beverages on weight outcomes have discrepancies in their results and conclusions
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
